Comparison of Long-Term Clinical Outcomes of Zirconia and Lithium Disilicate Prostheses: A Retrospective Cohort Study

Objectives: This study aimed to compare the 5-year cumulative survival rates and clinical outcomes of zirconia and lithium disilicate restorations in both tooth- and implant-supported prostheses, focusing on survival, technical and biological complications, as well as patient-reported satisfaction. Materials and Methods: A retrospective cohort of 200 patients treated with either zirconia (n = 100) or lithium disilicate (n = 100) fixed restorations between 2020 and 2024 was analyzed. Only cases with a minimum follow-up of 5 years were included. Clinical parameters (fracture, chipping, retention loss, secondary caries, peri-implant complications), radiographic outcomes (marginal bone loss, periapical stability), and patient satisfaction (VAS scores for esthetics and function) were evaluated. Kaplan-Meier survival analysis and subgroup analyses (anterior/posterior, tooth-/implant-supported) were performed. Results: At 5 years, the cumulative survival rate was 94.0% for zirconia and 89.0% for lithium disilicate (p = 0.210). Technical complications were lower with zirconia (14.0% vs. 21.0%, p = 0.182), including fewer fractures (6.0% vs. 12.0%, p = 0.126). Chipping (5.0% vs. 7.0%) and debonding (3.0% vs. 2.0%) showed no significant differences. Biological outcomes were comparable: secondary caries (7.0% vs. 11.0%, p = 0.332), endodontic issues (4.0% vs. 6.0%, p = 0.516), peri-implant mucositis (9.0% vs. 12.0%, p = 0.495) and peri-implantitis (3.0% vs. 5.0%, p = 0.470). Radiographically, periapical stability was preserved in most cases (93.0% vs. 89.0%, p = 0.317), and the mean marginal bone loss was slightly lower with zirconia (0.46 +/- 0.25 mm vs. 0.53 +/- 0.30 mm, p = 0.148). Patient-reported outcomes were favorable in both groups, with esthetic VAS scores of 8.6 vs. 8.2 (p = 0.072) and functional scores of 8.4 vs. 8.0 (p = 0.085). Zirconia was rated higher in posterior/implant-supported cases, while lithium disilicate was preferred in anterior restorations. Conclusions: Both zirconia and lithium disilicate restorations demonstrated favorable long-term outcomes, with zirconia trending toward superior mechanical reliability in posterior and implant-supported restorations, and lithium disilicate excelling in esthetic performance, particularly in anterior regions. Material selection should be guided by clinical indication, occlusal load distribution, and esthetic requirements.

Journal

BIOMIMETICS

Year

2025

Volume

10

Issue

11

eISSN

2313-7673

DOI

10.3390/biomimetics10110740

WoS UID

WOS:001624006300001